5 Essential Healthcare Revenue Cycle Management Strategies

Healthcare Revenue Cycle Management Strategies

Staffing shortages, cybersecurity concerns, vaccination difficulties, constantly shifting regulations, and a hundred other challenges face healthcare organizations today. With the right healthcare revenue cycle management strategies, however, leaders can also access specific tools, resources and solutions to effectively deal with them all, while also improving the ability to deliver safe and high-quality patient care.

By optimizing separate parts of the revenue cycle, these strategies can help organizations do more with less, while also shoring up common sources of errors and inefficiencies. With that in mind, here are the five most important healthcare revenue cycle management strategies for leaders to implement over the next year.

5 Essential Healthcare Revenue Cycle Management Strategies

Why is revenue cycle management important in healthcare? As the different aspects of healthcare delivery grow more complex, the management of each of those parts — billing, claims, and so on —  also becomes more difficult. From scheduling the initial appointment through insurance verification, claims processing and payment, each part of the patient experience is a critical slice of a larger pie.

By separately managing each aspect of that cycle, organizations can optimize the entire process, piece by piece. That means not just more quickly and consistently collecting payments, but also safeguarding against denied claims. It also means more efficiently and reliably carrying out tasks like insurance verification, missed payment monitoring, overdue collections, and much more — each of which has the potential to directly impact revenue.

This is nothing new — revenue cycle management has been a growing segment of the healthcare industry for the past decade. However, the details have changed. Strategies that worked a few years ago might not be geared to meet the challenges of today. And so, the best path forward is a review of the five core strategies that are still likely to generate successful revenue cycle management for healthcare organizations.

Strategy #1: Embrace Technology

A big reason why revenue cycle management has become so important is that so much of patient care is now digital. From appointment setting to telehealth technology, patients have come to expect an easy-to-use, technology-based experience. And companies that are still dragging their feet on keeping up with technology are missing an opportunity to hone a key revenue cycle management tool.  

To begin with, an organization’s entire system needs to be able to process and track data during every part of the patient lifecycle. When health IT and EHR systems are updated to meet today’s standards, the goal of optimizing the use and the management of that data becomes a far more realistic one.

Strategy #2: Focus on Organization

Embracing technology is also a necessary foundation in the even more important strategy of creating a central hub for all patient and institutional data. That means getting rid of all of those random sticky notes and unorganized spreadsheets in favor of a new, single system to collect all important data — for billing and coding, claims status, and everything else.

This may be a big step, requiring the help of a third-party expert to implement. But, once completed, this central hub of organized data will be your biggest asset in revenue cycle management. It’ll also provide other knock-on benefits like giving clinicians better access to important data, opening the door to automation-based improvements, and better protection against security breaches.

Strategy #3: Implement New Standards for Accuracy

Having a central hub of information also helps you ensure accuracy, which can reduce denied claims and missed payments. By training every team member in the use of the single system, you can make sure all data is entered the same way, each time. Doing so reduces errors while helping organizations better adapt to changing payer requirements and regulatory mandates.

When offered a consistent, easy-to-understand process to follow, workers can enter information much more quickly, helping to speed up claims processes and reduce the chance of missed payments. And, once trained in the process, team members will appreciate the lower level of labor that goes into gathering patient information, freeing up time for them to focus on other tasks.

Strategy #4: Improve Processes with Automation, AI & Analytics

With a new system in place to ensure accuracy, organizations can now boost efficiency even further by utilizing cutting-edge technology. For instance, automation can help drive significant efficiency in workflows relating to payer-provider communications or navigating new payer rules. And artificial intelligence (AI) can help pinpoint denied claims or other more complex errors by monitoring all data.

By automating certain aspects of the review process, and then using AI to safeguard against error, less time is required for menial, manual tasks. This saved time gives workers the freedom to focus on more patient-focused tasks, which could boost job satisfaction. And if enough processes can be automated, leaders could see room in their budget to hire more specialized workers to tackle more strategic tasks.

Applying analytical processes and data reporting is another important way to better manage information. Analytical review of all data helps keep providers alerted against unforeseen waster, and up to date for opportunities to engage patients — or to spot an endangered claim before it expires.

Strategy #5: Get the Help of a Third-Party Expert

It takes real expertise to leverage technology like AI, or even to implement a system that’s truly accurate and efficient. So, it should come as little surprise that many healthcare organizations choose to partner with a third-party specialist when it comes to implementing these critical revenue cycle management strategies.

As the industry continues to transition from fee-for-service to value-based care, and the healthcare revenue cycle continues to evolve along with those changes, real expertise is required to stay ahead of the game. And partnering with a specialized provider of healthcare managed services (MSP) or vendor management services (VMS), means getting premier access to that expertise on an ongoing basis.

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Need Help with Healthcare Revenue Cycle Management Strategies for Your Organization?

At CareerStaff Unlimited, we specialize in offering the kind of clinical workforce solutions that can help transform revenue cycle management. As a trusted name in healthcare recruitment and workforce services for decades, we’re standing by to help healthcare organizations of all types optimize key processes of their revenue cycle. Contact us today to learn more.

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